Post-Traumatic Stress Disorder
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Body, Movement & Expressive Arts Therapies

Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.

Many traumatic stress experts believe that it is insufficient to work with the mind alone. Because unhealed trauma wreaks havoc on the body, it makes perfect sense to include the body in the healing process.

yoga classThere are several types of coping skills that are beneficial for many types of problems and difficulties. In a sense, we might consider them generic coping skills. For instance, deep breathing and visualization exercises are used in treatments targeting both mind and body. Deep breathing is a technique that is used in many types of psychotherapies for its relaxation and self-soothing benefits. Likewise, heart attack survivors can benefit by using deep breathing techniques to lower their blood pressure, etc. Thus, much of what we discuss here is no new invention or discovery. In fact, many of these practices have been around for centuries. However, the specific uses of these methods in the resolution of trauma, stress, and abuse certainly merit mention.

Likewise, there are some non-specific interventions that have existed since the beginning of the twentieth century. For example, bioenergetics and dance therapy have long encouraged the use of the body in the healing process. Nonetheless, during the past twenty years we have witnessed an explosion in trauma interventions that specifically target the body. Unfortunately, many of these interventions do not yet have enough research behind them to earn a coveted slot on SAMHSA's registry. However, many trauma specialists are so impressed by the preliminary research, and the results they observe in their clinical practice, that the official "evidence-based" distinction is irrelevant to them. For these practitioners, there is sufficient evidence not to withhold these treatments.

In his most recent book, The Body Keeps the Score, internationally acclaimed trauma scholar Dr. Bessel van der Kolk (2014) directly endorses many of these interventions including:

  • neurofeedback,
  • psychomotor psychotherapy,
  • internal family systems,
  • somatic experiencing®,
  • sensorimotor psychotherapy®, and
  • multi-level use of innovative interventions such as drama/theater, dance, art, music, equine-assisted work, and yoga.

Dissatisfied with the results of traditional approaches and SAMHA's registry, many professionals use these interventions as their primary healing tools. Many trauma specialists would agree that a primary purpose of trauma treatment is so that people can feel safe and comfortable in their bodies. Thus, the use of these interventions, at least as an addition to other more conventional methods, simply makes good sense.

In 2012, a task force of the International Society of Traumatic Stress Studies (ISTSS) concluded that these alternative and expressive approaches to psychotherapy should continue to be investigated (Cloitre, M., Courtois, C. A., Ford, J. D., Green, B. L., Alexander, P., Briere, J., . . . & Van der Hart, O. 2012). Existing research shows the promise of these interventions thus far, yet more scientific investigation will be needed in the years to come in order for these interventions to become more mainstream. If the preliminary research proves correct, it will be exciting to see how the helping professions will incorporate these approaches into their therapeutic regimes.

Additionally, many of these approaches make good sense in light of what we've learned about the brain from neurobiologists. For a review, please refer to the section entitled, What causes the symptoms of trauma?. It may simply be a matter of time before treatment research catches up to what we've learned about the brain in the last several decades.

At the moment, many professionals consider these movement approaches (e.g., yoga, dance) "alternative" practices. However, many others think using the word "alternative" is laughable. These practices have existed as healing arts in other cultures for centuries, long before psychology and other sciences came on the scene. Certainly, there is enough evidence to demonstrate their efficacy for use as an addition to traditional psychotherapy.

As we have emphasized throughout, do your own homework. Find out what options are available in your community. Think about what might be a good fit for you and trust your instincts. If you don't feel particularly safe or comfortable at a yoga studio or fitness facility, there is no pressure to keep returning just because you've heard yoga is supposed to be good for you.

If you've tried traditional psychotherapy many times without improvement, it becomes tiring and discouraging to keep trying to find a recovery path. However, we encourage you to persevere. These emerging practices may prove helpful to you. If you are already in therapy and want to try one of these body approaches, talk to your practitioner and ask for recommendations. They might be able to refer you to someone especially good with trauma survivors. Even if you are not receiving any professional treatment, you can still find local community resources. In addition to an Internet search, sometimes natural food stores, public libraries, and health clubs have information of this sort. You may be surprised to find that many of these interventions may be available in your community (particularly yoga and other forms of meditative exercises like Tai Chi or Chi Gong). For information about specific approaches please review the Resources Section. Our list is a mere sampling; there are practitioners all over the world who have been doing innovative things with movement and creativity for years. Do some investigating to see if one of these programs may be a good fit for you in your healing journey.


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